在加速康复外科（ERAS）方案中，腹腔镜肝切除术与开腹肝切除术之间没有优势。
THERE ARE NO ADVANTAGES BETWEEN LAPAROSCOPIC AND OPEN LIVER RESECTIONS WITHIN AN ENHANCED RECOVERY PROGRAM (ERAS).
机构信息
Hospital Transito Caceres de Allende, Cirugía, Córdoba, Argentina.
Servicio de Cirugia Hepatobiliopancreatica, Hospital Josep Trueta, Girona, Espanha.
出版信息
Arq Bras Cir Dig. 2021 Oct 15;34(2):e1593. doi: 10.1590/0102-672020210002e1593. eCollection 2021.
BACKGROUND
The use of a successful Enhanced Recovery After Surgery (ERAS) in colorectal surgery favored its application in other organs, and hepatic resections were not excluded from this tendency. Some authors suggest that the laparoscopic approach is a central element to obtain better results.
AIM
To compare the laparoscopic vs. open hepatic resections within an ERAS to evaluate if there are any differences between them.
METHODS
In a descriptive study 80 hepatic resections that were divided into two groups, regarding to whether they were submitted to laparoscopy or open surgery. Demographic data, those referring to the hepatectomy and the ERAS was analyzed.
RESULTS
Forty-seven resections were carried out in open surgery and the rest laparoscopically; in the first group there was only one conversion to open surgery. Of the total, 17 resections were major hepatectomies and in 18 simultaneous resections. There were no differences between procedures regarding hospital stay and number of complications. There was a greater adherence to the ERAS (p=0.046) and a faster ambulation (p=0.001) in the open surgery.
CONCLUSION
The procedure, whether open or laparoscopically done in hepatic resections, does not seem to show differences in an ERAS evaluation.
背景
结直肠手术中成功的加速康复外科（ERAS）的应用使其在其他器官中得到了应用，肝切除术也不例外。一些作者认为腹腔镜方法是获得更好结果的核心要素。
目的
比较 ERAS 中腹腔镜与开腹肝切除术，评估两者之间是否存在差异。
方法
在一项描述性研究中，对 80 例肝切除术进行分组，根据是否接受腹腔镜或开腹手术进行分组。分析了人口统计学数据、肝切除术和 ERAS 相关数据。
结果
47 例采用开腹手术，其余采用腹腔镜手术；在第一组中，只有 1 例转为开腹手术。总共进行了 17 例大肝切除术和 18 例同期切除术。在住院时间和并发症数量方面，两种手术方式之间没有差异。开腹手术的 ERAS 更规范（p=0.046），术后下床活动更快（p=0.001）。
结论
在 ERAS 评估中，肝切除术无论是开腹还是腹腔镜手术，似乎都没有差异。
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